The effect of early dexamethasone administration on bronchopulmonary dysplasia in preterm infants with respiratory distress syndrome.
OBJECTIVE
This study was carried to evaluate the effect of early administration of dexamethasone on the incidence of bronchopulmonary dysplasia (BPD) and/or death in surfactant-treated preterm infants with respiratory distress syndrome (RDS).


METHODS
In a multicenter, double-blind, placebo-controlled trial, 109 preterm infants with RDS and birth weights between 700 and 1600 gm, who were treated with mechanical ventilation and surfactant, were randomly assigned before 36 hours of life to receive dexamethasone (n = 55) or placebo (n = 54) for 12 days.


RESULTS
There were no differences in the incidence of BPD and/or death between groups. However, fewer patients in the dexamethasone group were oxygen-dependent at 36 weeks after conception (8% vs 33%, p < 0.05). The dexamethasone group had a lower incidence of necrotizing enterocolitis (0% vs 9%, p < 0.05). The incidence of arterial hypertension, hyperglycemia, and sepsis was not affected by the treatment. Basal and poststimulation serum cortisol levels did not differ between groups.


CONCLUSIONS
The administration of dexamethasone early in the course of RDS does not decrease the incidence of BPD and/or death in preterm infants. However, dexamethasone may reduce oxygen dependency at 36 weeks after conception.
Tapia
J L
JL
Departamento de Pediatría, Hospital Clínico Universidad Católica, Santiago, Chile.
Ramírez
R
R
Cifuentes
J
J
Fabres
J
J
Hübner
M E
ME
Bancalari
A
A
Mercado
M E
ME
Standen
J
J
Escobar
M
M
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D001997:Bronchopulmonary Dysplasia / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control; D003907:Dexamethasone / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D011663:Pulmonary Surfactants / Q000627:therapeutic use; D012121:Respiration, Artificial; D012127:Respiratory Distress Syndrome, Newborn / Q000188:drug therapy* / Q000401:mortality / Q000628:therapy; D016019:Survival Analysis
D000893:Anti-Inflammatory Agents; D011663:Pulmonary Surfactants; D003907:Dexamethasone